Dyslipidemia in patients with chronic kidney disease (CKD) is not uncommon and increases overall risk for cardiovascular disease (CVD). Of incident patients with ESRD:

• 46% had total cholesterol levels well over 160 mg/dL and
• 40% exceed the desired threshold for triglycerides (150 mg/dL) (1).

While complex to manage, there are several resources available. In 2003, KDOQI released its Clinical Practice Guidelines for Managing Dyslipidemias in CKD (2). To summarize, the guidelines state for all adults and adolescents with CKD:

• Assessment should include a complete fasting lipid profile with total cholesterol, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides.
• Dyslipidemias should be evaluated upon presentation (when the patient is stable), at 2–3 months after a change in treatment or other conditions known to cause dyslipidemias; and at least annually thereafter.

Nephrology Nursing Standards of Practice and Guidelines for Care offers guidelines for assessment, intervention, and patient education to achieve these outcomes (3). In part, the stated desired patient outcomes in the management of dyslipidemia are, the patient will:

• Achieve lipoprotein levels within targeted ranges
• Demonstrate a reduction in modifiable risk factors that contribute to the development of CVD.

All of this is informative, but how can we implement this in a simple and sustainable manner? How do we create an action plan that will achieve the desired patient outcomes?

Clinical Solutions offers a three-pronged approach to Triglycerides (TG) and HDL management.
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